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"My plea is simple! Tell the truth about your symptoms and contacts to health workers."

Yes/No Check-box
By Sodzi Sodzi-Tettey

Accra
Ghana

In Accra, Ghana... She walked into the hospital calmly, confidently, very well-spoken and articulate. Staff quickly directed her to the screening table where nurses wearing appropriate protective equipment started taking her history. No, she had not travelled recently. No, there was no cough. No, she had had no contact with anyone with respiratory signs. She only had a low-grade fever and wanted to see a doctor.

In the consulting room, the history flipped. Yes, she had recently returned to Accra from the United Kingdom. Yes, she had a slight cough and had probably been in close contact with others with colds and running noses. She also felt she had a little fever the previous day. In other words, she had deliberately lied to the health workers at the screening desk!

Doctors and nurses subsequently advised her to endeavor to give an accurate history for everyone’s good. She became very upset and retorted that she had the right to decide at which point in the care process to tell the truth about her signs and symptoms. Clearly fitting the case definition for coronavirus infection, she was quarantined, and a test requested. Now, in the tense wait for the results, health workers and the patient are all sitting on tenterhooks. A week or so ago, I also heard about some travelers to Ghana allegedly taking paracetamol tablets [a medication that treats fever and pain] midair in order to escape quarantine measures on account of detected fever.

My plea is simple! Tell the truth about your symptoms and contacts to health workers.

Health workers are under enormous pressure. Before we can record objective parameters — temperature, chest signs, etc. — before we can take samples for laboratory confirmation of COVID-19, all we have to lead us to the right diagnosis is an accurate and truthful history. Sending health professionals on a wild goose chase serves no one’s interests; certainly not yours, not theirs, not your close contacts’ and not the wider community’s. Please tell health professionals the truth about your symptoms, your travel history, and your close contacts, and trust that the information will be handled with the necessary discretion.

This also highlights the enormous high risks faced by health professionals at the frontline as they fight to curtail this pandemic, dealing in some instances with patients who appear yet to fully grasp the seriousness of the COVID-19 situation. The need for eternal vigilance and adequate practical measures to protect themselves as they engage patients cannot be overemphasized. Leaders and managers have an urgent duty at this time to provide resources to frontline staff. A letter reportedly written by health workers at a major hospital in Ghana calling for adequate supplies of personal protective equipment, and appropriate masks, ought to be treated as a priority and the gaps expeditiously addressed not just at that hospital but at all screening and treatment centers nationwide. Rather than the public sometimes subjecting those health workers seeking to remove themselves from imminent danger to danger, let us move purposefully in support to address the root causes of their concerns and provide them the needed psychological and material support to fight COVID-19.

Further, health professionals and other staff caring for suspected or confirmed cases have the right to expect managers to “provide adequate IPC [infection prevention and control] and PPE [personal protective equipment] supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity,” according to the WHO. In addition, health workers need appropriate working hours with breaks if they are not to burn out; and provision of access to counselling services, especially in instances where doctors and nurses have reportedly self-quarantined for hours while awaiting test results of patients seen by them without a word of comfort from managers, sometimes long after positive test results are announced publicly.

In the meantime, health professionals are encouraged to treat patients with compassion and respect and to maintain patient confidentiality.

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